https://scholars.lib.ntu.edu.tw/handle/123456789/567259
標題: | Clinical outcomes in cytomegalovirus-positive posner-schlossman syndrome patients treated with topical ganciclovir therapy | 作者: | CHIEN-CHIA SU FUNG-RONG HU Wang T.-H. JEHN-YU HUANG PO-TING YEH CHANG-PING LIN I-JONG WANG |
公開日期: | 2014 | 出版社: | Elsevier Inc. | 卷: | 158 | 期: | 5 | 起(迄)頁: | 1024-103100 | 來源出版物: | American Journal of Ophthalmology | 摘要: | Purpose: To evaluate the clinical characteristics and therapeutic outcomes of cytomegalovirus (CMV)-positive Posner-Schlossman syndrome patients undergoing topical ganciclovir treatment.Design: Retrospective, comparative, and interventional case series.Methods: One eye of each of 126 consecutive Posner- Schlossman syndrome patients was investigated using aqueous polymerase chain reaction (PCR) between January 2006 and June 2013. The initial presentations and follow-up data of the CMV-positive patients (68 eyes) andCMV-negative patients (58 eyes)were compared.Results: Severe endothelial cell loss (P <.001) and a higher number of eyes requiring glaucoma filtering surgery (P = .017) were observed in CMV-positive Posner- Schlossman syndrome patients. All CMV-infected eyes treated with continual topical 2% ganciclovir exhibited an undetectable CMV level at the following taps. During follow-up, the average number of antiglaucomatous agents decreased, and a similar frequency of intraocular pressure (IOP) spikes was observed in both groups (P=.358). Patients with CMV-positive eyes with a disease duration over 5 years were likely to require glaucoma surgery (P = .024, log-rank test). All patients receiving surgery exhibited CMV-negative PCR during the IOP attack, but experienced severe peripheral anterior synechiae and pigment clogging. Both groups exhibited a similar endothelial cell decrease (P=.243) and probability of progressive endothelial cell loss (P = .219, log-rank test).Conclusion: Ganciclovir treatment was effective for clearing the viral load, assisting the IOP control, and preserving the corneal endothelium of CMV-positive Posner-Schlossman syndrome patients. Early diagnosis and proper treatment could decrease the risk of advanced glaucoma and avoid glaucoma surgery in long-lasting cases. ? 2014 by Elsevier Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84908657446&doi=10.1016%2fj.ajo.2014.08.007&partnerID=40&md5=ebdc239466392723bbb4b5cfc90dda65 https://scholars.lib.ntu.edu.tw/handle/123456789/567259 |
ISSN: | 0002-9394 | DOI: | 10.1016/j.ajo.2014.08.007 | SDG/關鍵字: | antiglaucoma agent; ganciclovir; antivirus agent; ganciclovir; virus DNA; anterior eye chamber; antiviral therapy; Article; corneal endothelial cell loss; Cytomegalovirus; cytomegalovirus infection; drug efficacy; drug treatment failure; endothelium cell; female; follow up; glaucoma; glaucoma surgery; human; intraocular pressure; lens; major clinical study; male; medical record review; polymerase chain reaction; Posner Schlossman syndrome; retrospective study; trabecular meshwork; virus load; visual acuity; aqueous humor; comparative study; Cytomegalovirus Infections; Eye Infections, Viral; genetics; isolation and purification; microbiology; middle aged; syndrome; topical drug administration; treatment outcome; virology; Administration, Topical; Antiviral Agents; Aqueous Humor; Cytomegalovirus; Cytomegalovirus Infections; DNA, Viral; Eye Infections, Viral; Female; Follow-Up Studies; Ganciclovir; Humans; Male; Middle Aged; Polymerase Chain Reaction; Retrospective Studies; Syndrome; Treatment Outcome |
顯示於: | 醫學系 |
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